Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#3096 of 11K

99172

HCPCS Procedure Code

HCPCS code 99172 is the #3,096 most-billed Medicaid procedure code, with $2.5M in payments across 441K claims from 2018–2024. The national median cost per claim is $7.43.

Total Paid

$2.5M

0.00% of all spending

Total Claims

441K

Providers

314

Avg Cost/Claim

$6

National Cost Distribution

How much do providers bill per claim for 99172? Based on 129 providers billing this code nationally.

Median

$7.43

Average

$7.64

Std Dev

$13.29

Max

$131.46

Percentile Distribution (Cost per Claim)

p10
$0.05
p25
$0.44
Median
$7.43
p75
$9.31
p90
$13.54
p95
$17.84
p99
$50.25

50% of providers bill between $0.44 and $9.31 per claim for this code.

90% bill between $0.05 and $13.54.

Top 1% bill above $50.25.

About This Procedure

HCPCS code 99172 was billed by 314 providers across 441K claims, totaling $2.5M in Medicaid payments from 2018–2024. This code was used for 428K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.43

Providers Billing

129

National Spending

$2.5M

Avg/Median Ratio

1.03×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99172

#ProviderTotal Paid
11194855155$349K
2Unm Hospital

Albuquerque, NM · General Acute Care Hospital

$243K
31760462253$129K
41154370344$113K
51265441877$105K
61033429394$104K
71275605594$101K
81578625661$95K
91851386106$85K
101497863229$84K
111609896018$82K
121245283977$71K
131699868703$69K
141780692400$57K
151881804581$52K
161932116191$49K
171982768032$43K
181376875229$39K
191053408948$35K
201205805181$34K

Showing top 20 of 314 providers billing this code